Measuring CSSD performances

which tools for which objectives?

Dr Christine DENIS, Pharmacist, Stérinord , Lille University

Hospital, France

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Content

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•Background

•How to measure CSSD’s performances

•KPIs

•Operationally

Background

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• Public health expenses control: health is priceless, but costly

• Expenses’ control must apply to CSSD

• Differences versus health care activities:

• Not profit-oriented• CSSDs’ specificities scarcely understood by hospitals’

decision makers & top management• Reprocessing costs not well identified• Difficult benchmarking• Lack of financial data participates in the lack of recognition

Background

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To improve , CSSD shall:

• demonstrate its efficiency / implement a production costcontrol

• show its profitability = its internal and external performance = operational steering

• prove its projects and investments’ relevance = strategy

• Should lead to recognition

How to measure CSSD’s performances

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• Already achieved items via QMS:

• QMS based on indicators

• ISO 9001 standard’s application is linked to the implementation of processes improvement and compliance indicators

• Each CSSD detains at least activity basic data

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•CSSD is a production activity, thus industrial⇒ copy industrial processes,

•Indicators and Key Performance Indicators(KPI)

How to measure CSSD performances

INDICATOR: what is it?

• Indicators = statistics data used:• To measure current conditions

• To forecast future conditions

• Shows state / level of something

• One condition: designed for measurable things

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KPI: definition

Key Performance Indicator

= measures to assess the performance of a department

Warning!: difference between metrics and KPIs

• KPIs are linked to an objective.• Example : process time • Decision makers use them to ensure that goals (strategic and operational) are met.

• Metrics show gross volume of a variable or a parameter.Example : number of reprocessed sets.

(A metric becomes a KPI when linked to a target value).

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KPIs in a few words

• Belong to a progress approach and drive it

• Enable operational steering and decision making

• Enable managers and staff to evaluate their actions’ efficiency

• Can be individual or team-wide

Peter Drucker (a founder of modern management)

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“You can’t steerwhat you can’t

measure”

KPIs in a few words

•Answer to specific stakes:

• Evaluation

• Diagnosis

• Communication

• Information

• Motivation

• Continuous improvement (link with QMS)

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KPIs in a few words

• To be integrated in scorecards

• Gives access to essential management data to steer an activity

• At a higher level, panels are compiled and integrated in the organization’s strategic management / steering

• Allow to identify counter-performance areas and recovery plans implementation

• Used in benchmarking

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Which KPIs?

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•Select KPIs adapted to your needs to serve / support your strategy and objectives

•Start form strategic objectives, then aimoperational objectives’ timed reach

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A good KPI is:

• Specific : it must answer to a clear and precise goal

• Measurable: related data must be quantifiable and must enable to scan the route towards objective

• Achievable: it supports achievable objectives and must enable to implement actions

• Relevant: it shall serve the Department’s strategy, short and long term

Which KPIs?

Method: from data to scorecards and analysis

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Collect

data

Format

data

Analyse

data

Method: from data to scorecards and analysis

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• Data come from:• Information Systems like tracking system

• Figures and information reported by managers, teams, HR responsibles

• Extracted and implemented according to pre-definedrules

Collect data

Method: from data to scorecards and analysis

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• Excel or Business Objects tools

• Select most explanatory diagrams

• Presented in scorecards and/or charts

(global vision)

Format data

Method: from data to scorecards and analysis

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•“Critical” phase•Relate to background

•Comprehend indicators in their globality

Analyse data

Operationally , in a CSSD department

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Indicators are related to:

Activity

Measure what

the

Department

operates

Produc

-tivityQuality HR ….

Measure the

efficiency of

the

Department,

Measure

qualitative

performance

of the

Department

Measure

Human

ressources

data

Measure ….

Activity KPI:

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Measure what the Department operates

• Number of Sets / single instruments / Work Units (SF2S)

• Allotment by:

• Service

• Type of service

• Site

• Sets / single instruments

• Sterilization mode (steam, LTS)

• ...

Benefits:

• Better understanding

• Capacity to anticipatevariations

• Projection capacity

French Work Unit (FWU)

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FWU Op Theaters Dentistry Wards

Pouch 15 15 10

Pouch handpiece 30 30 -

Set 1 to 10 instruments 30 20 15

Set 11 to 60 instruments 110

Set > 60 intruments 160

Loan sets 160

Extra for LTS 80 or 160

Productivity KPI:

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• Measure what is produced by :• Workstation• Agent • Machine • Shift (morning , afternoon, night)• Etc.

• Calculate process time (total, logistics, assembly, packaging, cleaning….)

• Cost price per set, per pouch, per Work unit

Benefits:

• Performance level

• Improvement areas

• New organizations’ evaluation

Quality KPI:

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• Clients’ complaints towards sterilization

• Sterilization’ s complaints towards Clients

• By type,

• By frequency

• Per agent

• Per day

• ….

Benefit:

• Performance level

• Improvement areas

Human ressources KPI:

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•Absenteism

•Population pyramid

•Level of training

•Years of service

•….

Benefit:

• anticipation

• steering

Other KPI:

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•Operating sets’ turnover rate

•Emergency requests’ analysis

•Etc….Benefit:

• Exact investments

• Arguments/discussion withOR

Negotiation tool:

• Justify needs (HR, equipments, etc.)

• Argue / support in case of new strategies (projects in reorganization, grouping, outsourcing, etc.)

• ROI

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To summarize : KPIs in sterilization

Management tool:

• Steering

• Communication:• Clients

• General management

• Team

• Anticipation / strategy

• Objective evaluation of new organizations

• Evidence

• Closely related to QMS

• Supporting Lean Management, Six Sigma…• To be shared with:

• Top management

• Clients

• ….

• Opportunity to showcase our services’ operations and performances and demonstrate our control

• Internal management tool when regularly shared and analysed with teams

Know

Let know

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KPIs in sterilization

• More productive dialogue with top management: understandeach/other

• Constructive dialogue with Clients based on facts and not feelings

• Share elements with teams

• Easy evaluation of all changes in the organisations :currentsituation/new situation

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Benefits:

When to share:

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• With teams:• Production meeting by teams leaders at every shift start

• Weekly team meeting

• With the clients:• Users’ committee every 2 months

• Operating theaters’ committees

• With top management: every 3 months

Improved

only if

measured*

Only measured if

understood

Only

understood if

described and

shared

* William Edwards Deming30

Conclusions

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• CSSD manager must showcase and demonstrate his/her Department’s performance

• Indicators and KPIs are essential to our business

• Conditions to get the best:

• Necessary but not enough• Reliable if relevant (well designed and analysed in line with background), thus

not questionable

• Powerful tool in management, steering, communication and negotiation

• Enable to objectively evaluate evolutions or new constraints

• TO SHARE absolutely

• Time consuming

Conclusion

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• Use of KPIs = philosophy of transparency

• KPIS’ share = trust’s engine

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